The ultimate goal of the Clinical Services component of the St. Luke's- Roosevelt Hospital Sickle Cell Center is the establishment of uniformly excellent care of all patients with sickle cell disease, of all ages, provided through a well-organized clinical base. The care must extend through the spectrum of medical services from primary and preventive through crisis and tertiary, as well as beyond the purely medical into those ancillary activities - education, employment, finances, etc. - essential for the quality of life. If maximum effort is made to address the multiplicity of patient needs, he or she is more likely to remain under care in the program. The achievement of these goals requires a well trained, experienced committed and empathic staff, working together as a cohesive unit. The immediate goals of the subprojects of the center are: 1) To reduce the negative impact of recurrent pain in sickle cell disease through patient education and advocacy, by sickle cell staff augmented by volunteers, as well as by the extended use of patient controlled analgesia in the younger child, via nurse and parent, and to sites other than the inpatient ward, e.g., the emergency room. 2) To study age-related pitted red blood cells, and spleen function via spleen scans and other tests in patients with CC disease, compared to SC and SS patients since preliminary investigation has indicated that these patients have high pitted red blood cell counts, probably unrelated to spleen dysfunction. This project has clinical relevance for CC patients, and by extension to SC patients. 3) To explore certain aspects of immune function in sickle cell and CC patients, namely circulating immune complexes, immune complexes on the surface of red blood cells, classical and alternate complement pathways, and complement C3b receptors function activity. The demonstration of the cause of immune problems in sickle cell disease patients can potentially lead to prevention or therapy.